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Conclusions: A large trial of transfusion strategies in older mechanically ventilated patients is feasible. This pilot trial found a nonsignificant trend toward lower mortality with restrictive transfusion practice.

This work was led by Edinburgh University and the Edinburgh Clinical Trials Unit.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website (http://journals.lww.com/ccmjournal).

Supported, in part, by the Chief Scientists Office, Scotland (CZB/4/698); the Scottish National Blood Transfusion Service, the NHS Lothian Academic Health Science Centre; and the Transfusion Medicine Education and Research Foundation. These funders had no direct influence or role in design and conduct of the study; collection, management, analysis, or interpretation of the data; or preparation, review, or approval of the article.

Dr. Walsh has consulted for GE Healthcare and has received grant support from National Institute of Healthcare Research (NIHR) Health Technology Agency. Dr. Boyd received travel reimbursements and grant support from Chief Scientists Office. Dr. Lewis has given expert testimony for Merck and has received grant support from Medical Research Council (MRC)/Chief Scientists Office, Scotland (CSO)/ Arthritis Research UK (ARUK)/etc. Dr. Wyncoll received grant support from Chief Scientists Office, Scotland and Health Technology Assessment 09/144/51; reimbursement for travel to Edinburgh (setup and close out meeting); served as a board member for Astellas and Covidien; consulted for Convatec and Baxter; lectured for Astellas, Eli Lilly, Pfizer, Sage Products Inc, Iskus Health, and Smiths/Portex; received payment for development of educational presentations from Astellas; and has stock options in Biovo Technologies). Drs. Watson, Hope, Krishan, Forbes, Ramsay, Wallis, Cairns, and Cole received grant support from Chief Scientists Office, Scotland. Dr. Pearse received grant support from Chief Scientists Office and is a National Institute for Health Research (UK) Clinician Scientist.